ALFENTANIL, A NEW SHORT-ACTING OPOIDE - HEMODYNAMIC AND RESPIRATORY ASPECTS

  • 1 January 1983
    • journal article
    • research article
    • Vol. 32  (6) , 265-271
Abstract
The hemodynamic and respiratory-depressive effects of 20 and 40 .mu.g/kg of alfentanil in 54 patients with coronary bypass operations were compared with a control group (n = 36). The measurements were carried out at the following 3 different times, each lasting over a 10 min period: before induction of anesthesia, but after premedication with flunitrazepam; during anesthesia; and during extracorporeal circulation (standardized conditions). Preoperative and intraoperative investigations showed reduced pulse rate, mean arterial pressure, left ventricular pressure and arterial perfusion pressure during extracorporeal circulation. As cardiac output remained constant in the awake patient, peripheral vasodilatation was predominant. During anesthesia, reduction in cardiac output or N2O may have caused the decrease in pressure. During the preoperative period an increase in wedge pressure, mean pulmonary artery pressure, right atrial pressure and pulmonary vascular resistance occurred from the 3rd min after injection, caused by vasconstriction during apnea. In the intraoperative period this did not occur. The respiratory depression (Pa02 [arterial partial pressure of O2]: -34%, PaCO2 [arterial partial pressure of CO2]: +29%) resembles that after fentanyl, except that it starts earlier and lasts for a shorter time. All effects after alfentanil are similar to those of fentanyl.

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